Rest tremor in advanced essential tremor: a post-mortem study of nine cases

Louis, Elan D.; Asabere, Nana Yaw; Agnew, Angus; Moskowitz, Carol; Lawton, Arlene; Cortés, Etty; Faust, Phyllis L.; Vonsattel, Jean Paul

doi:10.1136/jnnp.2010.215681

Cited by 79 publications

(53 citation statements)

References 30 publications

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“…We have shown previously that the presence of isolated rest tremor (i.e., in the absence of other features of parkinsonism) in advanced ET is not an indicator of the presence or emergence of Lewy body pathology in these cases [16]. Nonetheless, the emergence of rest tremor in some cases, particularly if accompanied by bradykinesia or rigidity, may be an early manifestation of emerging Lewy body disease.…”

Section: Discussionmentioning

confidence: 97%

Prevalence and correlates of rest tremor in essential tremor: cross‐sectional survey of 831 patients across four distinct cohorts

Louis

Hernández

Michalec

2015

Euro J of Neurology

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Background Essential tremor (ET) is among the most commonly encountered neurological disorders. Its hallmark feature is kinetic tremor. However, other tremors may also occur in ET patients, creating considerable diagnostic confusion among treating physicians. Hence, characterizing the prevalence and clinical accompaniments of these other tremors is of value. Surprisingly, there are few data on the prevalence of rest tremor in ET patients, and even fewer data on the clinical correlates of such tremor. Methods 831 patients in four distinct settings (population, genetics study, study of environmental epidemiology, brain bank) underwent a detailed videotaped neurological examination that was reviewed by a senior movement disorders neurologist. Rest tremor was evaluated in several positions (seated, standing, lying down). Results The prevalence of rest tremor while seated or standing was lowest in the population-based setting (1.9%), highest in the brain bank study (46.4%), and intermediate in the remaining two settings (9.6% and 14.7%, respectively). Rest tremor was restricted to the arms and was not observed in the legs. Rest tremor was associated with older age, longer disease duration (in some studies), greater tremor severity and, to some extent, the presence of cranial tremors. Conclusions Rest tremor can be a common clinical feature of ET. Its prevalence is highly dependent on the setting in which patients are evaluated, ranging from as low as 1% to nearly 50%. Rest tremor seems to emerge as a clinical feature with advancing disease. The anatomical substrates for this type of tremor remain unknown at present.

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Section: Discussionmentioning

confidence: 97%

Prevalence and correlates of rest tremor in essential tremor: cross‐sectional survey of 831 patients across four distinct cohorts

Louis

Hernández

Michalec

2015

Euro J of Neurology

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“…ET cases with rest tremor also had more severe postural and kinetic tremor and were more likely to have head tremor than those without rest tremor [13]. Another study of nine ET cases with rest tremor reported a median disease duration of 42 years [15]. All cases had moderate to severe action tremor of the arms and cranial (head, jaw or voice) tremor [15].…”

Section: Bedside Examination: Distinguishing Et From Pdmentioning

confidence: 99%

“…Another study of nine ET cases with rest tremor reported a median disease duration of 42 years [15]. All cases had moderate to severe action tremor of the arms and cranial (head, jaw or voice) tremor [15]. Rest tremor was bilateral in seven cases, and in five cases, the side with more severe rest tremor was concordant with the side with more severe action tremor [15].…”

Section: Bedside Examination: Distinguishing Et From Pdmentioning

confidence: 99%

“…All cases had moderate to severe action tremor of the arms and cranial (head, jaw or voice) tremor [15]. Rest tremor was bilateral in seven cases, and in five cases, the side with more severe rest tremor was concordant with the side with more severe action tremor [15]. One study at a tertiary referral center compared 38 PD patients with 11 ET patients with rest tremor [17].…”

Section: Bedside Examination: Distinguishing Et From Pdmentioning

confidence: 99%

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Distinguishing essential tremor from Parkinson's disease: bedside tests and laboratory evaluations

Thenganatt

Louis

2012

Expert Review of Neurotherapeutics

125

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Distinguishing essential tremor from Parkinson’s disease can be challenging, both in the early stages of these diseases and as these diseases progress. Various tremor types (rest, postural, kinetic and intention) may be seen in both essential tremor and Parkinson’s disease. Furthermore, with time, the two diseases may coexist within a single patient. Detailed clinical examination with attention to specific features of tremor (frequency, amplitude, pattern and distribution) and associated neurological findings may help distinguish patients with the two diseases. Laboratory testing may provide information that further aids in differentiating the two diseases. These tests include accelerometry and surface electromyography, spiral analysis, dopamine transporter imaging, olfactory testing and, eventually, postmortem histopathology. These tests have limitations and their diagnostic utility requires additional study.

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“…In one tertiary referral center, the patients with rest tremor had kinetic tremor that was more severe, more disseminated, and of longer duration than ET patients without rest tremor 69. Although the pathogenesis of rest tremor in ET is unknown,70 it could be related to pathologic spreading to extracerebellar circuits in patients with severe, long-standing, and disseminated disease. Alternatively, it may result from a pathological interaction between the basal ganglia and the cerebello-thalamo-cortical circuits 71…”

Section: The Neurodegenerative Modelmentioning

confidence: 99%

Essential Tremor: A Neurodegenerative Disease?

Benito‐León

2014

Tremor and Other Hyperkinetic Movements

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Rest tremor in advanced essential tremor: a post-mortem study of nine cases

Cited by 79 publications

References 30 publications

Prevalence and correlates of rest tremor in essential tremor: cross‐sectional survey of 831 patients across four distinct cohorts

Prevalence and correlates of rest tremor in essential tremor: cross‐sectional survey of 831 patients across four distinct cohorts

Distinguishing essential tremor from Parkinson's disease: bedside tests and laboratory evaluations

Essential Tremor: A Neurodegenerative Disease?

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